Erick Alexanderson-Rosas1,2, Nilda Espinola-Zavaleta3, Ernest V Garcia4, Amalia Peix5, Teresa Massardo6, Luz M Pabon7, Neftali Eduardo Antonio-Villa8, Isabel Carvajal-Juarez3, Claudio T Mesquita9, Amelia Jimenez-Heffernan10, Chetan Patel11, Ganesan Karthikeyan11, Alka Kumar12, Sadaf Butt13, Mani Kalaivani11, Victor Marin14, Olga Morozova15, Diana Paez15. 1. Department of Nuclear Cardiology, National Institute of Cardiology Ignacio Chavez, Juan Badiano Nº 1, Colonia Seccion XVI, Tlalpan, P.C. 14080, Mexico City, Mexico. alexandersonerick@gmail.com. 2. Department of Physiology, Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico. alexandersonerick@gmail.com. 3. Department of Nuclear Cardiology, National Institute of Cardiology Ignacio Chavez, Juan Badiano Nº 1, Colonia Seccion XVI, Tlalpan, P.C. 14080, Mexico City, Mexico. 4. Emory University, Atlanta, GA, USA. 5. Nuclear Medicine Department, Institute of Cardiology, La Habana, Cuba. 6. Hospital Clinico Universidad de Chile, Santiago, Chile. 7. Fundacion Valle del Lili, Cali, Colombia. 8. Facultad de Medicina, Universidad Nacional Autonoma de Mexico, Mexico City, Mexico. 9. Hospital Universitario Antonio Pedro, Niteroi, Brazil. 10. Hospital Juan Ramon Jimenez, Huelva, Spain. 11. All India Institute of Medical Sciences, New Delhi, India. 12. Dr. B L Kapur Memorial Hospital, New Delhi, India. 13. Oncology and Radiotherapy Institute (NORI), Islamabad, Pakistan. 14. Fundacion Cardioinfantil, Bogota, Colombia. 15. Nuclear Medicine and Diagnostic Imaging Section, International Atomic Energy Agency, Vienna, Austria.
Abstract
BACKGROUND: Left ventricular diastolic dyssynchrony (LVDD) can be assessed by gated myocardial perfusion single-photon emission computed tomography (GMP-SPECT). LVDD is an area of interest in subjects who underwent cardiac resynchronization therapy (CRT). The aim of this post hoc analysis was to assess the role of LVDD in subjects with CRT who were followed up at 6-month period. MATERIAL & METHODS: Left ventricular diastolic dyssynchrony was assessed by GMP-SPECT at baseline and after CRT procedure in 160 subjects from 10 different cardiological centers. CRT procedure was performed as per current guidelines. Outcomes were defined as improvement in ≥1 New York Heart Association (NYHA) class, left ventricular ejection fraction (LVEF) by 5%, and reduction in end-systolic volume (ESV) by 15% and 5% points in Minnesota Living with Heart Failure Questionnaire. LVDD was defined as diastolic phase standard deviation ≥40 ± 14°. RESULTS: Improvement in NYHA functional class occurred in 105 (65.6%), LVEF in 74 (46.3%), decrease in ESV in 86 (53.8%), and Minnesota score in 85 (53.1%) cases. Baseline LV diastolic standard deviation was 53.53° ± 20.85 and at follow-up 40.44° ± 26.1283; (P < 0.001). LVDD was not associated with improvement in clinical outcomes at follow-up. CONCLUSION: CRT improves both systolic and diastolic dyssynchrony values at 6-month follow-up. LVDD at baseline is correlated with cardiac functionality at follow-up, but not with overall favorable clinical outcomes.
BACKGROUND: Left ventricular diastolic dyssynchrony (LVDD) can be assessed by gated myocardial perfusion single-photon emission computed tomography (GMP-SPECT). LVDD is an area of interest in subjects who underwent cardiac resynchronization therapy (CRT). The aim of this post hoc analysis was to assess the role of LVDD in subjects with CRT who were followed up at 6-month period. MATERIAL & METHODS: Left ventricular diastolic dyssynchrony was assessed by GMP-SPECT at baseline and after CRT procedure in 160 subjects from 10 different cardiological centers. CRT procedure was performed as per current guidelines. Outcomes were defined as improvement in ≥1 New York Heart Association (NYHA) class, left ventricular ejection fraction (LVEF) by 5%, and reduction in end-systolic volume (ESV) by 15% and 5% points in Minnesota Living with Heart Failure Questionnaire. LVDD was defined as diastolic phase standard deviation ≥40 ± 14°. RESULTS: Improvement in NYHA functional class occurred in 105 (65.6%), LVEF in 74 (46.3%), decrease in ESV in 86 (53.8%), and Minnesota score in 85 (53.1%) cases. Baseline LV diastolic standard deviation was 53.53° ± 20.85 and at follow-up 40.44° ± 26.1283; (P < 0.001). LVDD was not associated with improvement in clinical outcomes at follow-up. CONCLUSION: CRT improves both systolic and diastolic dyssynchrony values at 6-month follow-up. LVDD at baseline is correlated with cardiac functionality at follow-up, but not with overall favorable clinical outcomes.
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